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How to Identify Children at Risk for Severe Acute Malnutrition

Photo: Courtesy of Tate Bierut

Sara Shaban Hendrixson

Director of Communications, Project Peanut Butter (PPB)

Project Peanut Butter (PPB) isn’t just interested in eradicating child malnutrition, but in preventing it from becoming an issue at all. In 2017, PPB launched a maternal health study aimed at supporting malnourished pregnant women and thus preventing stunting in utero. 

In 2019, PPB has taken on another innovative project, this time to identify children at the highest risk of becoming severely malnourished (SAM). 

Patching the cracks

In 2017, the World Health Organization changed its recommendations to no longer include supplementary foods in the treatment for moderately acute malnourished (MAM) children, and recommend only nutritional counseling. This puts children at the highest risk of adverse outcomes (progression to SAM or death) more susceptible to deterioration failing food interventions. PPB aims to prevent deterioration in these ”high-risk” children by expanding treatment criteria.

Currently, the best way to identify a child with acute malnutrition is based on the size of their upper arm. Based on review of previous data, PPB has designed a novel treatment criteria for identifying children with high-risk MAM with a new arm circumference intervention point. Children who fall into this category are considered to be at high-risk for developing SAM. Other characteristics of high-risk children include not being breastfed and being primarily raised by someone other than their mother.

Where we are

PPB operates clinics where high-risk children are enrolled in community-based feeding programs and where lower-risk children are referred to nutritional counseling through mother support groups. These groups are part of an established program in Sierra Leone and the current national recommendation for MAM children. The intervention treatment for high-risk children incorporates both mother support counseling and a packet (525 calories’ worth) of ready-to-use-food daily. Children continue treatment until they have reached a healthy state, or until 12 weeks of therapy have elapsed. 

Identifying high-risk children before they fall into SAM is a vital step toward the eradication and prevention of child malnutrition and a long-term mission of PPB.

Sara Shaban Hendrixson, Director of Communications, Project Peanut Butter (PPB), [email protected]

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